Continuous glucose monitors show which foods can harm us
In a nutshell
“Every day in the UK there are 25 diabetic amputations”
“Individual feedback is central to behavioural change”
Continuous glucose monitors show which foods may be harmful
This short article is based on the talk given by Dr. David Unwin at the Second Annual Scottish PHC meeting in Glasgow on 2nd November 2024.
Dr. Unwin spoke mostly about his Type 2 Diabetes patients and started with a shocking statistic:
“Every day in the UK there are 25 diabetic amputations”
He reminded us that high blood glucose is poisonous. Obviously it affects so-called diabetics but is also implicated in heart disease (by harming blood vessels) and cancer (eight including colorectal and prostate).
Dr. Unwin’s focuses on diabetic patients. Over his 40-year career he has witnessed a 10-fold increase in patients presenting with T2D. In his time, he has been able to get 147 patients into drug-free (including insulin) remission.
He described three themes which I’ll present here, namely:
Continuous glucose monitors are a key tool in patient education self-help
Critical measures of blood glucose
Specific continuous glucose monitor
Patient education self-help
Dr. Unwin believes conditions such as T2D can be managed effectively and often reversed when people are able to lower their blood glucose by changing their lifestyle. Importantly, he believes that “individual feedback is central to behavioural change”.
The most important way to allow patients trying to manage their blood glucose is to give them a continuous glucose monitor (CGM). The CGM allows an individual to see immediately how their blood glucose is affected by different types of food. This is important because everyone is different.
To give an example of the types of food that cause blood glucose to rise too high, Dr. Unwin quoted one of his patients who reported that the following foods caused an unacceptable spike in their blood glucose:
Milk
Pineapple
Banana
Breaded chicken
Tinned soup
Boiled carrots
Dumplings
Cream crackers
Spare ribs (presumably the sauce)
Breakfast cereals
Latte (presumably the milk)
Branston pickle
Armed with this information, Dr. Unwin’s patient avoided those foods and consequently lowered their blood glucose to a consistently safe level. She was able to enter a state of drug-free remission of their T2D within three months.
Dr. Unwin used the foods listed above to remind us that starches and grains “will soon be sugar”. By this he meant that our bodies digest things like bread crumbs, dumplings, cream crackers, and breakfast cereals and quickly turn them into glucose in our blood.
Critical Measures of Blood Glucose
Two measures of blood glucose that can be measured using a CGM are HbA1c and time in range (TIR)
HbA1c
HbA1c is a three-month average of blood glucose concentration frequently measured and used for patient management. Having this information allows an individual to know if their blood glucose has been on average within an acceptable range.
Time in Range
TIR has emerged more recently and is intended to be used in addition to HbA1c. As its name suggests, it goes beyond the three-month average and indicates whether or not blood glucose was above or below an acceptable range even if over a three-month average it was considered acceptable.
TIR provides a more accurate measure of blood glucose fluctuations. Many environmental variables can affect blood sugar levels, including food, exercise, medications, sleep and stress.
For anyone interested in digging into the current debate associated with blood glucose levels, it may be worth understanding time in tight range (TITR). This link provides insight to the concept.
Specific CGMs
Using a CGM to gather HbA1c and TIR data offers invaluable insight to anyone interested in their metabolic health whether associated with T2D, obesity, heart disease, high blood pressure or other symptoms of poor diet.
Two brands of CGM were mentioned in the conference, namely:
• Dexcom